OFFICIAL ENTRY FORM€¦ · Web viewRelease and Indemnity Agreement. I agree to be bound by The...
Transcript of OFFICIAL ENTRY FORM€¦ · Web viewRelease and Indemnity Agreement. I agree to be bound by The...
OFFICIAL ENTRY FORM
OFFICIAL ENTRY FORM
Hobie Sprint Series 2009
Nedlands Yacht Club
Skipper
First Name:
Last Name:
Address:
City:
State:
Country:
Postal Code:
Telephone:
Fax:
E-mail:
Date of Birth:
Club:
Hobie Assoc:
Crew
First Name:
Last Name:
Address:
City:
State:
Country:
Postal Code:
Telephone:
Fax:
E-mail:
Date of Birth:
Club:
Hobie Assoc:
Boat Details
Sail Number:
Boat Name:
Sponsor/Product:
Events
H16 Youths |_|
Womens |_|
Masters |_|
Grand Masters |_|
H16 Open |_|
Fees
$50
Payment
Amount Enclosed: $
Release and Indemnity Agreement
I agree to be bound by The Racing Rules of Sailing (RRS) and all other rules that govern this event. I agree that none of the organisations, persons involved in the running of this event, sponsors, promoters, class association or any other involved persons or parties accepts liability for damages due in negligence or any other reason whatsoever while conducting or connected with this event for injury, to property or person, I may suffer while participating in the event and while upon the event premises. I know the risks of danger to myself and my property while preparing for and participating in the event, and while upon the event premises, relying upon my own judgment and ability, assume all such risks of loss and hereby agree to reimburse all costs to those persons or organizations connected with this event for damages incurred as a result of my negligence.
Skipper signature
Crew signature
I certify that I hold third party liability insurance to a minimum value of $AUD 5 million in accordance with the Notice of Race.
Skipper signature
Please forward completed form and fees to:
Steve Sturgeon or
Taylor Booth
Enquiries
E-mail: taylor- [email protected]
Steve- [email protected]
Event Website:http://www.hobiesprintseries.com
Amount received: $
Paid by: Cash |_| Cheque |_|
Receipt No:
Initials
Official use only
HCAWA 2009-10 Nationals ENTRY FORM 090203.docPage 1 of 18/10/2009